The influence of cognitive factors in the treatment of obesity: Lessons from the QUOVADIS study

Abstract

Weight-loss maintenance remains a problematic issue in lifestyle modification programmes, but a small percentage of individuals are able to maintain a significant long-term weight loss. This means cognitive mechanisms may effectively contrast the biological pressures to regain weight arising from an obesiogenic environment. Aims of this review were to summarizes and synthesizes the data on the cognitive factors associated with program attrition, weight loss and weight maintenance derived from the QUOVADIS (QUality of life in Obesity: eVAluation and DIsease Surveillance), an observational study on quality of life in 1944 obese patients seeking treatment in 25 medical centres in Italy, and discuss its results in light of other literature. The data obtained suggest that some cognitive factors are associated with treatment discontinuation (namely higher weight-loss expectations, appearance-based primary motivation for weight loss, and unsatisfactory progress), while others with the amount of weight lost (i.e., increased dietary restraint and reduced disinhibition) or with long-term weight loss maintenance in patients who interrupted the treatment (i.e., satisfaction with results achieved, confidence in being able to lose weight without professional help). All these findings have important clinical implications.

Keywords: Attrition; Cognitive factors; Obesity; Treatment; Weight loss; Weight maintenance.